• Lymphedema

    (Primary Lymphedema; Secondary Lymphedema)


    The lymph system helps your body fight illness. Lymph fluid travels throughout the body in lymph nodes and vessels. If these nodes or vessels are damaged or missing the fluid builds up. Fluid build-up in the arms or legs is called lymphedema. There are two types of lymphedema:
    • Primary lymphedema is uncommon and occurs because people are born without lymph nodes and vessels.
    • Secondary lymphedema occurs when there is injury to the lymph nodes or vessels.
    Damaged Lymph Nodes
    damaged lymph
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    While there is no cure for lymphedema, it can be controlled. If you suspect you have this condition, contact your doctor promptly for treatment.


    Lymphedema can be caused by a variety of factors:
      Primary lymphedema
      • Born without lymph vessels and nodes
      • Milroy’s disease
      • Meige disease
      • Late-onset lymphedema
    Planned Lymph Removal for Cancer Treatment
    lymph nodes to be removed
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    Risk Factors

    These factors increase your chance of developing lymphedema. Tell your doctor if you have any of these risk factors:
    • Radiation treatment
    • Cancer
    • Infection
    • Parasites—tropical/subtropical regions
    • Overweight
    • Poor diet


    If you have any of these symptoms do not assume it is due to lymphedema. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
    • Swelling in arms, legs, fingers, or toes
    • Loss in range of motion
    • Infection
    • Aching, pain, or discomfort
    • Heaviness or tightness of skin
    • Your clothes, shoes, or jewelry feel tight
    • Hardening of the skin
    • Redness of skin


    Cases of lymphedema can vary from mild to severe. Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    Tests may include the following:
    • Measurement of your arms and/or legs—to assess the severity of fluid build-up
    • Lymphoscintigraphy—test that uses dye to trace its travel through your lymph system
    • MRI scan —magnetic waves are used to make pictures of body structures; used to look at tissue affected by lymphedema
    • CT scan —type of x-ray that uses a computer to make images; used to look at tissues affected by lymphedema
    • Duplex ultrasound or Doppler ultrasound —test that uses sound waves to make images; used to look at blood flow and rule out blood clot


    Talk with your doctor about the best plan for you. Options include the following:


    Your doctor or physical therapist may show you exercises to drain fluid out of your arm or leg. Massage may also be used to help fluid draining. Sometimes external pumps are used to help drain the fluid build-up.


    Compression stockings, sleeves, or bandages are often used to direct fluid away from your affected arm or leg. You may be shown how to apply a compression device.
    Compression stockings, sleeves, or bandages are often used to direct fluid away from your affected arm or leg. You may be shown how to apply a compression device.


    Areas of lymphedema are at risk for infection. Your doctor may prescribe an antibiotic to prevent or treat infection. If the condition is painful your doctor may suggest or prescribe a pain reliever.


    Surgery to remove extra tissue from your arm or leg may be considered in severe cases.


    If you are at risk for developing lymphedema, there are measures you can take to help reduce your chance of getting the condition:
    • Do not allow anyone to take blood or your blood pressure on your affected arm or leg.
    • Wear a medical bracelet warning of your risk for developing lymphedema.
    • Keep your affected arm or leg clean.
    • Avoid crossing your legs or carrying items on your shoulder if either area is at risk.
    • Keep hands and feet protected by wearing gloves and shoes.
    • Maintain a healthy weight and eat properly.
    • Use an electric razor to shave.
    • Use sunscreen when outdoors.
    • Avoid ice packs or heating pads to the affected area.
    • If you had lymph nodes in your armpit removed during breast cancer surgery, participating in a physical therapy program may help to prevent lymphedema.


    National Cancer Institute http://www.cancer.gov

    National Lymphedema Network http://www.lymphnet.org/


    Canadian Cancer Society http://www.cancer.ca/

    Lymphedema Association of Quebec http://www.infolympho.ca/


    Lymphedema. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/lymphedema/DS00609 . Accessed November 3, 2008.

    Lymphedema. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/patient . Accessed November 3, 2008.

    Lymphedema. Society for Vascular Surgery website. Available at: http://www.vascularweb.org/patients/NorthPoint/Lymphedema.html . Accessed November 3, 2008.

    What is lymphedema? The National Lymphedema Network website. Available at: http://www.lymphnet.org/lymphedemaFAQs/overview.htm . Accessed November 3, 2008.

    1/22/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010;340:b5396.

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